Established in 1963, the state highway designation was extended to Traskwood from 1965 to 1995, when it was truncated at Tull, forming the current alignment.

[6] Highway 291 serves western Grant County, which is within the Piney Woods ecoregion, known for flat, rolling plains and oak-hickory-pine forest.

The route begins at a junction with Highway 46 at the unincorporated community of Dogwood near Jenkins' Ferry State Park and runs north through a sparsely populated, forested area.

The highway continues north, becoming more rural as it travels, before entering the small town of Tull.

[9] On August 30, 1995, the designation between Tull and Traskwood was deleted in exchange for an extension of Highway 229 at the request of the Saline and Grant County judges.